A Clinical Study of the Use of SR Vaccum Suction Cannula in the Management of Atonic PPH at Tertiary Care Hospital

Background: Creating negative pressure inside the uterine cavity results in shrinking of uterus which can assist the natural physiological process of contraction and retraction to stop atonic postpartum haemorrhage. Methods: Twenty five women with different risk factors for atonic PPH like obstructed prolonged labour, accidental haemorrhage, PIH, anaemia complicating pregnancy, multifetal pregnancy, and hydramnios, either alone or in combination, and who delivered either normally or by caesarean section were included in this study. Age, parity, gestational age at delivery was recorded. The uterine portion of the cannula was inserted into the uterine cavity up to the level of fundus immediately after placental delivery in both cases of vaginal and caesarean deliveries. The nipple of the cannula was connected to suction machine with thick walled flexible non collapsible suction tube. A negative pressure of 650 mmHg was created inside the uterine cavity and maintained for 10-15mints. Application of negative pressure was repeated every hour for 10mints for 3hours. The cannula was removed one hour after last suction procedure. The blood collected in suction bottle was measured and recorded. Results: Complete cessation of bleeding which was associated with contraction and firm retraction of uterus was observed in mostly women within 4mns after initiation of procedure. The amount of blood collected in suction bottle ranged from 50ml to 350ml. Conclusion: Vacuum shrinking of uterus is a very effective physical method which can assist the natural physiological process of contraction and retraction to stop atonic postpartum haemorrhage. This simple, cost effective, life-saving, and fertility saving technique, which can avoid laparotomy can be made available in any setting, and can become the first defence against atonic PPH.